Varni James W, Shulman Robert J, Self Mariella M, Nurko Samuel, Saps Miguel, Saeed Shehzad A, Bendo Cristiane B, Patel Ashish S, Dark Chelsea Vaughan, Zacur George M, Pohl John F
*Department of Pediatrics, College of Medicine, Texas A&M University, College Station †Department of Pediatrics, Baylor College of Medicine, Houston ‡Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Boston, MA §Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL ||Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH ¶Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil #Division of Pediatric Gastroenterology, Children's Medical Center of Dallas, University of Texas Southwestern Medical School, Dallas **Department of Psychology, Texas A&M University, College Station ††Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah, Salt Lake City.
J Pediatr Gastroenterol Nutr. 2015 Sep;61(3):323-9. doi: 10.1097/MPG.0000000000000795.
Patient-reported outcome (PRO) measures of gastrointestinal symptoms are recommended to determine treatment effects for irritable bowel syndrome (IBS) and functional abdominal pain (FAP). Study objectives were to compare the symptom profiles of pediatric patients with IBS or FAP with healthy controls and with each other using the PedsQL Gastrointestinal Symptoms and Gastrointestinal Worry Scales, and to establish clinical interpretability of PRO scale scores through identification of minimal important difference (MID) scores.
Gastrointestinal Symptoms and Worry Scales were completed in a 9-site study by 154 pediatric patients and 161 parents (162 families; IBS n = 46, FAP n = 119). Gastrointestinal Symptoms Scales measuring stomach pain, stomach discomfort when eating, food and drink limits, trouble swallowing, heartburn and reflux, nausea and vomiting, gas and bloating, constipation, blood in poop, and diarrhea were administered along with Gastrointestinal Worry Scales. A matched sample of 447 families with healthy children completed the scales.
Gastrointestinal Symptoms and Worry Scales distinguished between patients with IBS or FAP compared with healthy controls (P < 0.001), with larger effect sizes (>1.50) for symptoms indicative of IBS or FAP, demonstrating a broad multidimensional gastrointestinal symptom profile and clinical interpretability with MID scores for individual PRO scales. Patients with IBS manifested more symptoms of constipation, gas and bloating, and diarrhea than patients with FAP.
Patients with IBS or FAP manifested a broad gastrointestinal symptom profile compared with healthy controls with large differences, indicating the critical need for more effective interventions to bring patient functioning within the range of healthy functioning.
推荐使用患者报告结局（PRO）指标来衡量胃肠道症状，以确定肠易激综合征（IBS）和功能性腹痛（FAP）的治疗效果。本研究的目的是使用儿童版生活质量量表（PedsQL）胃肠道症状量表和胃肠道担忧量表，比较IBS或FAP患儿与健康对照者之间以及他们彼此之间的症状特征，并通过确定最小重要差异（MID）分数来建立PRO量表分数的临床可解释性。
在一项9个地点的研究中，154名儿科患者和161名家长（162个家庭；IBS组n = 46，FAP组n = 119）完成了胃肠道症状量表和担忧量表。除胃肠道担忧量表外，还使用了胃肠道症状量表，该量表测量胃痛、进食时胃部不适、饮食限制、吞咽困难、烧心和反流、恶心和呕吐、气体和腹胀、便秘、便血以及腹泻。447个有健康儿童的家庭组成的匹配样本完成了这些量表。
与健康对照者相比，胃肠道症状量表和担忧量表能够区分IBS或FAP患者（P < 0.001），对于指示IBS或FAP的症状，效应量更大（>1.50），显示出广泛的多维度胃肠道症状特征以及各个PRO量表MID分数的临床可解释性。IBS患者比FAP患者表现出更多的便秘、气体和腹胀以及腹泻症状。
与健康对照者相比，IBS或FAP患者表现出广泛的胃肠道症状特征，差异很大，这表明迫切需要更有效的干预措施，以使患者功能恢复到健康功能范围内。
